brimhall webinar 12-8-2010.ppt · 12/8/2010  · an introduction to functional diagnosis...

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

1

Welcome!

The 4 Quadrants of Functional Diagnosis

Sxs of a Functionally Disturbed Patient

• Fatigue or low energy

• Digestive disorders 

• Allergies

• Reduced immunity

• Hormonal dysfunction

• Sleep disturbances

• Anxiety or depressive tendencies• Reduced immunity

• Infertility

tendencies

• Weight fluctuations

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

2

What Is Functional Diagnosis?

Why Should You Bother?

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

3

The Four Essential Questions

Question # 1

Is there a dysfunction in this patient? If so where is it?If so, where is it?

The Four Essential Questions

Question # 2

What are the sources or causes of the dysfunction?dysfunction?

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

4

The Four Essential Questions

Question #3

What individualized treatments are needed?needed?

The Four Essential Questions

Question # 4

When has function been restored?

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

5

The Functional Diagnosis Hierarchyh ll i

1. The organs of the GI (digestion,  absorption, mucosal barrier)

2. The gallbladder3. Adequate detoxification and 

elimination (liver kidneys and

6. Adrenals7. Thyroid8. Sex Hormones9. Inflammation0 h S

Assess The Following:

elimination (liver, kidneys, and large bowel)

4. Optimal nutrient levels: tissue minerals , vitamins, and  EFAs

5. Blood Sugar Regulation & Oxidative Stress

10. The Immune System11. Cardiovascular System12. Kidney and Bladder

Quadrant #1

Functional Signs andSymptoms Analysis

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

6

Are You Re‐inventing the Wheel?

4 Common Problems

1. Spending too much time asking questions.

2. Not knowing what to do with all of the information they gather.

3 N l ki h i i i l hi i3. Never looking  at the initial history again.

4. Using symptoms as their primary means of tracking progress.

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

7

Health Assessment Questionnaires

• Tracking symptoms over time

• To encourage compliance

• To chart progress

• Substantiate the changes in their symptoms

• Assess Symptom Burden

Quadrant #2

Functional and NutritionalPhysical Exam Skills

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

8

A Y T hi YAre You Touching YourPatients Enough?

Functional and Nutritional P.E.

Skin Examination• Acne in adults

• Dilated capillaries

• Bumps on arms

• Dermatographism

• Low wound healing• Low wound healing

• Skin tags

• Vertical creases on forehead

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

9

Nail Examination

• Spooning of the nails

• Soft nails or poor growth

• Cracking of the tips of the fingers

• Red tips to fingers

• Ridging of the nails

The Mirrors of the Body

• Reflexology• Auricular Medicine• Pulse• Tongue

Ski• Skin• Applied Kinesiology• Neurological Reflexes

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

10

The HCL Point

The Enzyme Point

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

11

Quadrant #3

Functional In‐Office Testing

In‐Office Testing: Advantages• Easy to do

• Results back immediately

E t t t• Easy to re‐test

• Gateway testing

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

12

What are some of the tests you can do in‐office?

23

Functional Urinalysis Tests• Urine pH• Urine Specific Gravity• Bowel Toxicity test • Urine Sediment TestUrine Sediment Test• Urine Calcium• Urine Adrenal Stress Test 

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

13

Other In‐Office Lab Tests• Oxidata Free Radical Test

• Salivary pH

• Dr Bieler’s test

• Zinc taste test

• Zinc challenge

• Kane’s mineral testing

• Tissue mineral• Dr. Bieler s test

• Gastro test

• Metabolic pH Testing

Tissue mineral assessment

Summary of the Benefits• Easy assessment of dysfunction• “Gateway” test • Results are immediate • Testing is easily performed • Reference point to make sure treatment is working• Reference point to make sure treatment is working• No expensive equipment• A great source of  additional income

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

14

Quadrant #4

Functional Blood Chemistry Analysis

What You Need To Know

Blood Testing Is One of The M t I t t FDM T lMost Important FDM Tools 

for the Identification of Functional Disorders and for Disease Prevention

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

15

Blood Chem & CBC Analysis‐Th F i l A hThe Functional Approach

• Oriented around changes in physiology and not pathology.

b d i l h i l• Ranges based on optimal physiology 

• Use of tighter ranges

Some Other PointsSome Other Points

• Patterns and trends

• Fitting it into your FDM practice

• Approaching the Analysis

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

16

Sample Case‐34 year old female presents to clinic complaining of fatigue, 

weight gain, infertility, poor skin, and a history of increased cholesterol. Past hx. of oral contraceptive use. On Physical exam showed a BP of 106/68, pulse 82, weight 142 lbs, tenderness in RUQ, rest of abdominal exam unremarkable, Q, ,skin: bumps on arms, generally dry skin, flaky on upper arms, nails weak and split. Chem screen and CBC: Cholesterol 210, uric acid 1.03, thyroid panel normal, CBC normal.

Only two values outside the reference range:

U i A id 1 3 (3 0 5 5)

Sample Lab Case

Uric Acid 1.3  (3.0 – 5.5)

Cholesterol 5.30  (3.36 – 5.20)Some reasons for a decreased uric acid?

Fanconi’s syndromeWilson’s syndromeSIADHHeavy metal poisoningMalignancies (Hodgkin’s or 

multiple myeloma)Deficiency of xanthine oxidase

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

17

Complete Functional Analysis Using Foundational Hierarchy

GI dysfunction (Hypochlorhydria/ gastric inflammation, Pancreatic insufficiency, dysbiosis): globulins,  alk phos, MCV, WBCs,  Eosinophils, monos

Liver/Biliary dysfunction with EFA need: TGs,  LDL, Monocytes

Minerals: Magnesium, molybdenum and zinc: uric acid,  Alk phos,  GGT

Vitamin Need: (Anemia‐B12/folate, B6): HGB, MCV, RDW, GGT,  uric acid

Blood Sugar: Pancreas glucose, LDH

Blood sugar: Adrenal hypofunction: Potassium,  glucose, LDH

Renal insufficiency: Phos,  BUN/Creat ratio

Immune insufficiency: WBCs, Monos (recovery)

The Main Role1. The prevention of disease and dysfunction

2. The early detection of disease and dysfunction 

3. Advanced patient specific treatment techniques

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

18

Treatment Must…

• Address the underlying cause

• Respect biochemical individuality

• Focus on restoring physiological functiong p y g

• Cause no harm

Benefits to the Patient• Improved quality of health

• Reduced costs

• Reduced suffering

• Increased likelihood of a cure

• Reduced incidence of premature aging, mortality, and morbidity

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

19

S f l I l i fSuccessful Implementation of Functional Diagnosis

Requires a System

S f l I l i fSuccessful Implementation of Functional Diagnosis

Requires Support

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

20

S f l I l i fSuccessful Implementation of Functional Diagnosis

Requires Tools

Who Will Benefit?• Patients with inflammatory conditions

• Patients with energy issues

• Patients with blood sugar dysregulation

P i i h di l di• Patients with cardiovascular disease

• Hormonal issues

• Dermatological conditions

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com 

21

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An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

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